MISSY DEVER

Guest Commentary

The recently reported incident involving an elderly driver in Huntington, W.Va., with dementia has brought to public attention three very critical issues: recognition of signs indicating a person with dementia may no longer be safe to drive, preventing a person with a dementing illness from driving when skills are impaired and public safety. The Alzheimer’s Association clinical staff hears daily from families who grapple with this very challenging problem.

Studies have shown that poor driving performance corresponds with increased dementia severity. Driving is not only about using short-term memory, but it is a complex activity that requires good judgment, quick thinking and ability to react both mentally and physically to a road/driving problem situation safely. Unfortunately, most of the required cognitive skills necessary to be a safe driver are affected when one has a dementing disorder. Results from studies conducted at John Hopkins University and at the National Institute on Aging indicate that people who have Alzheimer’s disease, even in the early stages, routinely drive below the speed limit, get lost, and are involved in a disproportionate number of accidents.

There are clear signs of unsafe driving that family and friends should look for:

• Forgetting how to locate familiar places

• Failure to observe traffic signs and lights

• Multiple fender benders without any recollection of how they occurred

• Poor decisions while driving in heavy traffic (wrong turns against traffic)

• Becoming angry or confused while driving

Not all persons who have a dementia, particularly in the early stages, are unsafe drivers but it is important for families early on to be vigilant about a person’s skills. The best way to determine if a person is a safe and responsible driver is to assess driving skills through an on-the-road driving test, or other functional tests.

Once it’s clear the person with dementia can no longer drive safely, the family must act immediately to terminate the driving. If the person is in the early stages, family can include the person with dementia in the decision-making process but know that dementia affects a person’s ability to use reason and logic, thus their insight may also be impaired. Therefore objective testing and observation is the best way to judge the person’s skill on the road.

When the person is no longer able to make decisions, and fully understand consequences of actions, take no chances. Don’t assume that taking away a driver’s license will discourage driving. The Alzheimer’s Association has specific information available to help families create a plan to limit access to a car as well as terminate driving privileges.

This is one of the hardest decisions families face because it signifies loss of independence for the affected person, and realization for the family member that the dementia is worsening. Nonetheless families must remember always that this is a safety issue for their family member and the community. The overriding issue for the family should be to never put the affected individual in circumstances that cause them to deviate from the personal standards they held dear before they were affected by a dementing illness. Under no circumstances would a family member want the affected person to experience an accident and not be able to act in his/her best interests or the interests of others.

Families do not have to struggle alone. Local clinicians at the Southeastern Ohio Branch of the Alzheimer’s Association Greater Cincinnati Chapter are available to help families prepare a plan of action to address each step of this very difficult decision. This free service is available to all families in Jackson, Vinton, Gallia, Lawrence, Scioto, Adams, Brown and Highland counties. For more information, please call Missy Dever, LSW, Southeastern Ohio Branch Program Manager of the Alzheimer’s Association of Greater Cincinnati at 740-710-1821 or visit www.alz.org/cincinnati.

Missy Dever, LSW, is program manager of the Southeastern Ohio Branch, Alzheimer’s Association of Greater Cincinnati.